Provider Demographics
NPI:1114593134
Name:THARP, LAUREN CHRISTINE (NP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:CHRISTINE
Last Name:THARP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1978 PINEYWOODS RD
Mailing Address - Street 2:
Mailing Address - City:LEIGHTON
Mailing Address - State:AL
Mailing Address - Zip Code:35646-5246
Mailing Address - Country:US
Mailing Address - Phone:256-856-3965
Mailing Address - Fax:
Practice Address - Street 1:1978 PINEYWOODS RD
Practice Address - Street 2:
Practice Address - City:LEIGHTON
Practice Address - State:AL
Practice Address - Zip Code:35646-5246
Practice Address - Country:US
Practice Address - Phone:256-856-3965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162266363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily